Gwinnett County, Georgia

GWINNETT COUNTY, GEORGIA APPLICATION MANUAL FOR HUD ENTITLEMENT GRANT PROGRAMS

COMMUNITY DEVELOPMENT BLOCK GRANT [CDBG] PROGRAM

FISCAL YEAR 2009

APPLICATION PICKUP/SUBMISSION LOCATION:

GWINNETT COUNTY COMMUNITY DEVELOPMENT PROGRAM 575 OLD NORCROSS ROAD, SUITE A LAWRENCEVILLE, GEORGIA 30045-4367 TELEPHONE: 770-822-5190 FAX: 770-822-5193 TDD: 770-822-5195 Email: [email protected]

Or Download From: www.gwinnettcounty.com

APPLICATION SUBMISSION DEADLINE:

April 30, 2008 - 5:00 P.M.

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Gwinnett County Community Development Program 575 Old Norcross Road, Suite A Lawrenceville, Georgia 30045-4367 (770) 822-5190 Fax (770) 822-5193 TDD (770) 822-5195 email: [email protected]

Administered by W. Frank Newton, Inc. Program Management Firm for Gwinnett County An Equal Opportunity Employer Frank Newton, President

MEMORANDUM

TO: Prospective Applicant Organizations, Participating Cities, County Departments and Interested Parties

FROM: Craig Goebel Director

DATE: February 1, 2008

SUBJECT: 2009 Grant Application Cycle for CDBG, ESG and HOME/ADDI Grant Programs 2009 Grant Application Workshops

Fiscal Year 2009 Funding Cycle - Grant Applications Available For Qualifying Organizations

Gwinnett County is accepting applications for the FFY 2009 Community Development Block Grant (CDBG), Emergency Shelter Grants (ESG), and HOME/American Dream Downpayment Initiative (ADDI) Programs from public agencies [e.g., participating municipalities, County departments, local housing authorities, Gwinnett County Health Department, GRN Community Service Board], and from qualifying private non-profit organizations.

Beginning February 1, 2008, application materials/instructions may be obtained from:

(1) The Gwinnett County Website: www.gwinnettcounty.com.

Choose "Services" from the Menu Bar, then select “HUD 2009 Applications” to access the grant materials, download the Application Manuals, and save them onto your computer or network hard drive. Do not attempt to open the respective Application Manuals before saving them to your computer or network. If you have any problems downloading the Application Manuals, call telephone 770-822-5190 or TDD 770-822-5195 for assistance.

(2) Gwinnett County Community Development Program 575 Old Norcross Road, Suite A Lawrenceville, Georgia 30045-4367 Telephone 770-822-5190; FAX 770-822-5193; TDD 770-822-5195; email: [email protected]

Applications submitted for funding consideration must be physically received by 5:00 P.M., April 30, 2008 at:

Gwinnett County Community Development Program 575 Old Norcross Road, Suite A Lawrenceville, Georgia 30045-4367

Any applications received after this date/time will be returned to the applicants, and will not be considered for funding by Gwinnett County.

PERSONS PREPARING APPLICATIONS SHOULD RECEIVE THE ENTIRE APPLICATION MANUALS [SEPARATE MANUALS FOR CDBG, ESG, AND HOME/ADDI].

[Go To Page 2 of this Notice for information on Application Workshops]  

D:\Docs\2018-04-07\0e78c4d853f45fd59aaf2fde95c53f6f.doc MEMORANDUM Fiscal Year 2009 Applications and Application Workshops Page 2

APPLICATION WORKSHOPS

Two (2) Application Workshops are being conducted to assist interested applicants.

The same material will be discussed at both workshops.

Workshop #1

DATE: March 25, 2008

TIME: 1:00 P.M.

LOCATION: Gwinnett Justice and Administration Center Second Floor Conference Center, Room C 75 Langley Drive Lawrenceville, Georgia 30045-6900.

Workshop #2

DATE: March 25, 2008

TIME: 6:00 P.M.

LOCATION: Gwinnett Justice and Administration Center Second Floor Conference Center, Room C 75 Langley Drive Lawrenceville, Georgia 30045-6900.

The Registration Form for the Application Workshops is enclosed, and may be returned by FAX to 770-822-5193.

The mailing address for Application Workshop registration forms is:

Gwinnett County Community Development Program 575 Old Norcross Road, Suite A Lawrenceville, Georgia 30045-4367

Please submit a separate registration, by March 21, 2008, for each individual attending the workshops. Please complete the last portion of the registration form if you have Special Needs or if you need a language translator at the Workshops.

Copies of application materials will be available at the Application Workshops, but may also be downloaded from the Gwinnett County Website: www.gwinnettcounty.com, or may also be obtained at: email: [email protected]; Telephone 770- 822-5190; FAX 770-822-5193; or TDD 770-822-5195.

[Go To Last Page of this Notice for Application Workshop Registration Form]

D:\Docs\2018-04-07\0e78c4d853f45fd59aaf2fde95c53f6f.doc GWINNETT COUNTY COMMUNITY DEVELOPMENT PROGRAM FFY 2009 APPLICATION WORKSHOPS – CDBG, ESG, AND HOME/ADDI PROGRAMS GWINNETT JUSTICE AND ADMINISTRATION CENTER SECOND FLOOR, CONFERENCE CENTER, ROOM C 75 LANGLEY DRIVE LAWRENCEVILLE, GEORGIA 30045-6900

APPLICATION WORKSHOPS - REGISTRATION FORM

Please fill out the form, then fax, email, mail, or deliver a separate registration form to the Gwinnett County Community Development Program, for each person attending the Application Workshops.

The Workshops are available at no cost to participants; however registration is requested by March 21, 2008, due to space limitations, or to accommodate persons who have Special Needs or need Language Translation, as described at the bottom of this page.

If returning this form by Fax, send to 770-822-5193; or email to [email protected]

If mailing or delivering registration forms, the address is:

Gwinnett County Community Development Program 575 Old Norcross Road, Suite A Lawrenceville, Georgia 30045-4367 [Telephone: 770-822-5190/TDD 770-822-5195]

FY 2009 HUD Grants [CDBG, ESG, HOME/ADDI] - Application Workshops:

Check Workshop You Will Attend: March 25, 2008 – 1:00 P.M. GJAC CONF. CENTER, ROOM C March 25, 2008 – 6:00 P.M. GJAC CONF. CENTER, ROOM C

LOCATION: Gwinnett Justice and Administration Center [GJAC] - Second Floor Conference Center, Room C 75 Langley Drive Lawrenceville, Georgia 30045-6900.

ORGANIZATION REPRESENTED:

ADDRESS:

STATE ZIP CODE

DAY TELEPHONE NUMBER: ( ) AREA CODE NUMBER EMAIL ADDRESS: ************************************************************************************************ ********* Special Accommodations Needs Or Language Translation For Persons Attending The Workshops:

IF YOU HAVE SPECIAL NEEDS, AS INDICATED BELOW, PLEASE RETURN THE WORKSHOP REGISTRATION FORM BY MARCH 21, 2008 TO PERMIT GWINNETT COUNTY TO MAKE ARRANGEMENTS TO SERVE YOU.

I am hearing-impaired and need a person to "Sign" for me at the Workshops. Please Check Here:

I am a non-English speaker and need a translator at the Workshops. Please Check Here:

D:\Docs\2018-04-07\0e78c4d853f45fd59aaf2fde95c53f6f.doc The language I speak is:

D:\Docs\2018-04-07\0e78c4d853f45fd59aaf2fde95c53f6f.doc ]Table of Contents Items Page

Introduction 7 HUD Entitlement Grants - Gwinnett County 7 Community Development Block Grant Program and Awards to Gwinnett County 8 Information for Applicants 11 General Information for All HUD Entitlement Grant Programs - Gwinnett County 12 Obtain Application Materials From 12 Application Workshops 12 Application Review/Submission Deadlines 12 Late Submissions 12 Submit Completed Applications To 13 Application Submission Requirements - All Grants 13 Documents to be Submitted with Applications from Non-Profit Organizations 15 Key Dates in the CDBG Application Process 15 Gwinnett County Consolidated Plan 16 Community Development Goal and Priority Objectives 16 Housing Goals and Priority Objectives 17 Homeless Goal and Priority Objectives 18 HUD Objectives/Outcomes [New in FY 2009 CDBG Application Manual] 18 General Application Preparation Guidance 18 Community Development Block Grant [CDBG] Program Application Instructions 19 HUD Expenditure Requirements 20 Eligible and Ineligible Activities 20 Examples of Eligible Projects 20 Ineligible CDBG Activities 21 Maximum Period to Complete a Gwinnett County CDBG Activity 21 Reimbursements 21 Consolidated Plan Goals and Priority Objectives/HUD Objectives/Outcomes 21 Ways to Qualify a CDBG Project for Funding 22

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Areawide Projects 22 Census Data to Qualify Project Eligibility 22 Surveys to Qualify Project Eligibility 22 Limited Clientele Projects 22 Direct Service Projects 22 Presumed Benefit Projects 22 Real Property Acquisition or Easements 23 Floodplain/Flood-Prone, Historic, Environmental and Toxic Hazards 23 Other CDBG Application Preparation Guidance 23 Application Forms 26 Part I Submit for All Grant Programs 27 Part I Submission Checklist 29 Part II Submit for All Community Development Block Grant Program Applications 30 Items 1-3 [Submit for All CDBG Applications] 31 Item 4 [Submit Applicable Pages] 33 Public Facilities 33 A. Building Construction 33 B. Building Renovation 35 C. Water Projects [New] 38 D. Water Projects [Reconstruction] 40 E. Sewer Projects [New] 42 F. Sewer Projects [Reconstruction] 44 G. Drainage Projects [New] 46 H. Drainage Projects [Reconstruction] 48 I. Curb/Gutter Projects [New] 50 J. Curb/Gutter Projects [Reconstruction] 52 K. Street Projects [New] 54

Table of Contents - Page 2 Items Page

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L. Street Projects [Reconstruction] 56 M. Sidewalk Projects [New] 58 N. Sidewalk Projects [Reconstruction] 60 O. Parks Projects [New] 62 P. Parks Projects [Reconstruction] 64 Public Services 66 Q. Transportation Equipment Purchase 66 R. Health Services Equipment Purchase 68 S. Recreation Equipment Purchase 70 T. Computer Equipment Purchase 72 U. Audio-Visual Equipment Purchase 74 V. Other Equipment Purchase 76

Attachments 78 Attachment 1 Project Description Narrative – Submit for All Grants 79 Attachment 2 HOME Program/ADDI Required Attachment List [NOT REQUIRED FOR CDBG] 80 Attachment 3 CDBG Program Maximum Income Limits – 2007 81 Attachment 4 HOME Program/ADDI Maximum Income Limits – 2007 [NOT REQUIRED FOR CDBG] 82 Attachment 5 CDBG Program Project Beneficiaries Survey Form 83

INTRODUCTION

This Manual contains instructions and application forms to be used by organizations requesting Federal Entitlement Grants for housing/community development/homeless programs from Gwinnett County. The document also describes the grant programs and Gwinnett County's history of participation in the U.S. Department of Housing and Urban Development [HUD] Entitlement Grant programs [i.e., the Community Development Block Grant (CDBG) Program; the HOME Program; the American Dream Downpayment Initiative (ADDI), and the Emergency Shelter Grants (ESG) Program].

For questions about the grants or this Manual, contact:

Gwinnett County Community Development Program 575 Old Norcross Road, Suite A Lawrenceville, Georgia 30045-4367 [Telephone: (770) 822-5190] [FAX: (770) 822-5193] [TDD: (770) 822-5195] [Email: [email protected]]

HUD ENTITLEMENT GRANTS - GWINNETT COUNTY

Large cities [over 50,000 population] and Urban Counties [over 200,000 population] may receive grants directly from HUD as "Entitlement" grantees. Entitlement grantees receive grant funds each year through a formula allocation of grant funds, as determined by the amounts appropriated by the United States Congress. Gwinnett County receives three grants each year awarded directly by the United States Department of Housing and Urban Development [HUD]. The three grants received by Gwinnett County are:

 Community Development Block Grant [CDBG] Program  HOME Program/American Dream Downpayment Initiative [ADDI]  Emergency Shelter Grants [ESG] Program

Potential Grant Awards from HUD to Gwinnett County for the FFY 2009 Program Year:

 Community Development Block Grant [CDBG] Approximately $3.4 Million  HOME Program/American Dream Downpayment Initiative [ADDI] Approximately $1.2 Million  Emergency Shelter Grant [ESG] Approximately $140,000

Estimated Program Income will be received from the unscheduled repayment of housing loans made from prior year CDBG and HOME Program funds. The estimated amounts to be received in FY 2009 are: CDBG - $50,000; HOME Program/ADDI - $80,000.

The CDBG Program is presented in this document, including the manner in which Gwinnett County administers the grant.

COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) - ENTITLEMENT COMMUNITIES Summary

 The CDBG program is authorized by Title I of the Housing and Community Development Act of 1974, as amended, and provides annual grants on a formula basis to entitled Metropolitan Cities and Urban Counties to implement a wide variety of community and economic development activities directed toward neighborhood revitalization, economic development and the provision of improved community facilities and services.

 CDBG activities are initiated and developed at the local level based upon each community’s perceptions of its local needs, priorities, and benefits to the community.

 Each entitlement grantee receiving CDBG funds is free to determine what activities it will fund as long as certain requirements are met, including that each activity is eligible and meets one of the following broad national objectives: benefit persons of low and moderate income, aid in the prevention or elimination of slums or blight, or meet other community development needs of particular urgency [Presidentially-declared disasters].

 No more than 20 percent of grant (plus program income) funds can be spent for planning and administrative costs.

 No more than 15 percent of the grant (plus program income received during the preceding program year) can be spent for public service activities.

Purpose

To develop viable urban communities by providing Provide Decent Housing [DH] and a Create Suitable Living Environments [SL], and by expanding Create Economic Opportunities [EO], principally for persons of low and moderate income.

Type of Assistance/Eligible Grantees

HUD awards CDBG grant funds to Central Cities of Metropolitan Areas (MA's), as designated by the Office of Management and Budget; other qualified cities in MA's, and qualified urban counties with populations of at least 200,000 (excluding the population of entitled cities located within the boundaries of such counties).

 Gwinnett County became eligible for Entitlement CDBG Urban County funding in 1986.

 Gwinnett County invites CDBG applications each year from participating cities - Auburn, Berkeley Lake, Buford, Dacula, Duluth, Grayson, Lawrenceville, Lilburn Loganville, Norcross, Rest Haven, Sugar Hill, Snellville, and Suwanee. The HUD formula allocation takes into account each recipient's population, and other factors including the number of low- income persons, the level of persons living in poverty, and the numbers of older housing units. Every three years, municipalities located wholly or partially in Urban Counties must choose to remain a part of the Gwinnett Urban County CDBG Program, or to withdraw and participate in the statewide competition for CDBG funds administered by the Georgia Department of Community Affairs.

 Periodically [approximately every five years] Gwinnett County prepares a Consolidated Plan that identifies housing, community development and homeless problems and needs. The Plan also establishes measurable goals, priority objectives, and strategies to address these identified needs, and contains the County's proposed investments of HUD Entitlement Grant funds - and other resources - to address the problems/needs. Every year during the 5-year period of the Plan, the County prepares and submits to HUD an annual funding document [Annual Action Plan] that details the activities to be funded from that year's HUD Entitlement Grants, and lists other activities to be carried out by the grantee to address identified needs.

 Gwinnett County selects organizations and activities to be funded each year on a competitive basis.

 A publication prepared by the U.S. Department of Housing and Urban Development, Community Development Block Grant Program Guide to National Objectives and Eligible Activities for Entitlement Communities contains a detailed description of the many different types of eligible activities under the CDBG Program. Copies of the publication are available, at no cost, from the Gwinnett County Community Development Program [770-822-5190; FAX 770-822-5193; TDD 770-822-5195; email: [email protected].

Eligible Participants  Low- and moderate-income persons [housing rehabilitation applicants]  Non-profit organizations must have already received a tax-exempt certification [501(c)(3)] from the Internal Revenue Service [IRS] when the application(s) is submitted to Gwinnett County and are current with the registration requirements of the Georgia Secretary of State  Participating Gwinnett County cities  Gwinnett County Departments  Local Public Housing Authorities

Presumed Benefit Groups HUD permits grantees to serve certain specific groups of persons under the Low/Moderate Income Benefit National Objective. These are known as "Presumed Benefit” groups. Projects that serve these groups, exclusively, can be counted as 100% benefit to low- and moderate-income. The groups listed below are currently presumed by HUD to be made up principally of low- and moderate-income persons. The presumptive benefit is applicable, unless HUD challenges particular situations where there is substantial evidence that the persons in the group that an activity is to serve are most likely not principally low- and moderate- income persons.  Abused children  Elderly persons [age 62 and older]  Battered spouses  Homeless persons  Disabled adults [Severely Disabled - Per Census Definition]*  Illiterate adults  Persons living with AIDS  Migrant farm workers

*The Census Definition of Severely Disabled is:

Persons are classified as having a severe disability if they: (a) used a wheel chair or had used another special aid for six months or longer; (b) are unable to perform one or more "functional activities" or need assistance with an "ADL or IADL"; (c) are prevented from working at a job or doing housework; or (d) have a selected condition including autism, cerebral palsy, Alzheimer's disease, senility or dementia, or mental retardation. Also, persons who are under 65 years of age and who are covered by Medicare or who receive SSI are considered to have a severe disability.

Pre-Award Process The CDBG Program permits grantees to incur costs prior to the effective date of their grant award from HUD, under certain conditions. This process is known as a "pre-award."

The benefits of the Pre-Award Process for grantees carrying out large projects are:

 Projects can be completed in a shorter period of time, thereby saving considerable construction costs, rather than carrying out the large project in small annual increments.

 Grantees can draw the annual amount of the Pre-Award from HUD as soon as HUD loads their new grants into the U.S. Treasury.

 Current Gwinnett County HUD-approved Pre-Awards are: (1) construction of a Senior Services Center to serve predominantly low-income elderly persons [Total Pre-Award - $2.6 Million, consisting of $1,300,000 from FY 2008 and $1,300,000 from FY 2009; (2) construction of a Crisis Stabilization/Detoxification Center by the GRN Community Service Board [Total Pre-Award - $840,000 - $210,000, annually, in 2006 and 2008; and $420,000 in 2007. The pre-award process saves construction funds, by performing all the work in a much shorter time than would be possible when carrying out individual construction projects with each annual allocation of CDBG Program funds.

Funding History - CDBG Program Awards by HUD to Gwinnett County

Years Awards 1986 $1,227,000 1987 $1,267,000 1988 $1,280,000 1989 $1,343,000 1990 $1,370,000 1991 $1,555,000 1992 $1,694,000 1993 $2,119,771 1994 $2,300,000 1995 $2,633,000 1996 $2,617,000 1997 $2,633,000 1998 $2,653,000 1999 $2,672,000 2000 $2,773,000 2001 $2,935,000 2002 $2,953,000 2003 $4,744,000 2004 $4,827,000 2005 $4,615,969 2006 $4,200,238 2007 $4,225,356 2008 [Est.] $3,400,000 2009 [Est.] $3,400,000 Total $65,437,334

INFORMATION FOR APPLICANTS GWINNETT COUNTY, GEORGIA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FY 2009

INFORMATION FOR APPLICANTS

I. GENERAL INFORMATION FOR ALL HUD ENTITLEMENT GRANT PROGRAMS - GWINNETT COUNTY

A. OBTAIN APPLICATION MATERIALS:

Download from the Gwinnett County Website: www.gwinnettcounty.com. Select "Services" from the menu to access the grant materials, download the application documents, and save them on your computer's hard drive. If you have any problems downloading the materials, call 770-822-5190 for assistance.

Application materials are available from Gwinnett County in printed form:

Gwinnett County Community Development Program 575 Old Norcross Road, Suite A Lawrenceville, Georgia 30045-4367 [Telephone: (770) 822-5190][FAX: (770) 822-5193][TDD: (770) 822-5195][Email: [email protected]]

Application Materials Available Beginning February 1, 2008

B. APPLICATION WORKSHOPS

The Gwinnett County Community Development Program invites interested potential applicants to Application Preparation Workshops where these application materials will be presented, and where potential applicants may ask questions about the CDBG, HOME/ADDI, and ESG Programs.

Workshop #1

DATE: March 25, 2008 - 1:00 P.M. LOCATION: Gwinnett Justice and Administration Center - Second Floor Conference Center, Room C 75 Langley Drive Lawrenceville, Georgia 30045-6900.

Workshop #2

DATE: March 25, 2008 - 6:00 P.M. LOCATION: Gwinnett Justice and Administration Center - Second Floor Conference Center, Room C 75 Langley Drive Lawrenceville, Georgia 30045-6900.

Persons interested in attending the Application Workshops should notify the Gwinnett County Community Development Program by calling 770-822-5190 or fax 770-822-5193. An Application Workshops Registration form is contained in this Manual [see Page 4).

C. APPLICATION REVIEW/SUBMISSION DEADLINES

 March 31, 2008 – Last date to receive approval of survey methodology [see page 22 – Areawide Projects]  April 18, 2008 – 5:00 P.M. – Deadline for having draft applications reviewed by Gwinnett County Community Development Program. [Appointments are required – call 770-822-5190]  Application Submission Deadline: April 30, 2008 – 5:00 P.M. – Local Time

D. LATE SUBMISSIONS

Any applications that are received at the Gwinnett County Community Development Program Office (see address in item I.A, on this page) after the April 30, 2008, 5:00 P.M., Local Time, submission deadline will be returned to the applicant, and will be ineligible for funding.

Received is defined as: Applications are physically delivered or mailed sufficiently early to be physically received at the Gwinnett County Community Development Program Office by 5:00 P.M., April 30, 2008.

E. SUBMIT COMPLETED APPLICATIONS TO:

Gwinnett County Community Development Program 575 Old Norcross Road, Suite A Lawrenceville, Georgia 30045-4367 [Telephone: (770) 822-5190] [FAX: (770) 822-5193] [TDD: (770) 822-5195] [Email: [email protected]] [PLEASE DO NOT FAX OR EMAIL FINAL APPLICATIONS]

F. APPLICATION SUBMISSION REQUIREMENTS – ALL GRANTS

PERSONS PREPARING APPLICATIONS SHOULD RECEIVE THE ENTIRE APPLICATION MANUAL.

1. Agencies or organizations must have been authorized to submit applications by their respective governing boards, or from their agency directors, if so authorized by the governing boards.

2. Signatures from two different individuals are required in Part I of each application submitted: (1) the person who prepared the application; and, (2) an individual at a supervisory or governing board level who approved the application and authorized its submission to Gwinnett County.

3. Applications may be submitted in two ways: 1 Hardcopy submission or electronic submission. Table 1 presents details on each type of submission, specifying quantities of items required. Information is presented following Table 5 explaining how to make an electronic submission.

TABLE 1 SUBMISSIONS FOR ALL GRANTS Grants Submission Hardcopy w/Original Photocopy CD Type Signatures [Quantity] [Quantity] CDBG/HOME/ADDI/ESG Hardcopy 1 1 N/A CDBG/HOME/ADDI/ESG Electronic 1 N/A 1

TABLE 2 SUBMISSIONS FOR CDBG GRANTS Submission Part I Part II Part II Attachment Non-Profit Type With Original [Sections Section 4 1 Organization Signatures 1-3] [Appropriate [Quantity] Attachments [Quantity] [Quantity] Pages] [See Table 5] [Quantity] [Quantity] Hardcopy 1 2 2 2 1 Electronic 1 1 1 1 1 Additional required hardcopy documents to be submitted by Non-Profit Organizations are depicted in Table 5.

TABLE 3 SUBMISSIONS FOR HOME/ADDI GRANTS Submission Part I Part III Attachment Attachment Non-Profit Type With Original [Appropriate 1 2 Organization Signatures Pages] [Quantity] [Appropriate Attachments [Quantity] [Quantity] Items] [See Table 5] [Quantity] [Quantity] Hardcopy 1 2 2 2 1 Electronic 1 1 1 1 1 Additional required hardcopy documents to be submitted by Non-Profit Organizations are depicted in Table 5.

TABLE 4 SUBMISSIONS FOR ESG GRANTS Submission Part I Part IV Attachment Non-Profit Type With Original [Appropriate 1 Organization Signatures Pages] [Quantity] Attachment [Quantity] [Quantity] [See Table 5] [Quantity] Hardcopy 1 2 2 1 Electronic 1 1 1 1 Additional required hardcopy documents required of Non-Profit Organizations are depicted in Table 5.

TABLE 5 HARDCOPY ATTACHMENTS - NON-PROFIT ORGANIZATIONS [One Copy of Each Covers All Applications Submitted] [All Documents Must Bear the Name of the Applicant Organization] Grant Attachment [Quantity] CDBG Current tax-exempt certification [Section 501(c)(3)], that it has 1 HOME/ADDI received from the IRS prior to submission of the application. If the ESG organization has requested tax exempt status from the IRS, but the 501(c) (3) certification has not been received at the time of application submission, the organization will not be eligible for competition during this funding cycle. CDBG Incorporation approval and evidence of current good standing from 1 HOME/ADDI the Georgia Secretary of State [Current status available online from ESG http://www.sos.state.ga.us/corporations/corpsearch.htm ] CDBG HOME/ADDI Current by-laws 1 ESG CDBG HOME/ADDI Listing of current officers and current members of the Board of 1 ESG Directors, and their addresses as listed with the Georgia Secretary of State . CDBG Most recent audit or audited financial statement of the organization 1 HOME/ADDI submitting the application to Gwinnett County. The audit or audited ESG financial statement must be prepared and signed by the preparing independent auditor. The document must indicate to Gwinnett County that the organization has the fiscal capacity to carry out the project submitted for funding and a system of controls to protect the investment of HUD grant funds. CDBG Most recent IRS Form 990 or 990 EZ [Return of Organization Exempt 1 HOME/ADDI from Income Tax] Applicant must submit a copy of their organization’s ESG most recent submission of Form 990 or 990 EZ, and all schedules and attachments, to the Internal Revenue Service. Form 990 or 990EZ are required under section 501(c) of the Internal Revenue Code. CDBG Current Business Plan. The Business Plan is an indication to Gwinnett 1 HOME/ADDI County of how the organization carries out strategic planning, its evaluation ESG of performance, and its capacity to successfully carry out its proposed CDBG/HOME/ADDI/ESG projects.

Electronic Submission Instructions

Electronic submissions must be delivered to the Gwinnett County Community Development Program by the submission deadline. Electronically submitted applications must be submitted on a Compact Disk [CD] created using a CD-R or CD-RW drive on a Microsoft Windows compatible computer. Please perform a virus scan on file saved to the CD with a virus protection program, with current virus definitions, before submitting your application. Submissions by FAX or email are not permitted.

Electronically submitted applications must be prepared using Microsoft WORD using the application files provided by Gwinnett County. If an applicant does not have access to this software, or the ability to prepare applications electronically, Gwinnett County recommends that the application be submitted in hardcopy format.

One printed hardcopy of each entire application [with original signatures on Part I] must be submitted with the CD. This process will ensure that Gwinnett County has a hardcopy version of each application, in the event that the CD is damaged, or data on the CD is corrupted.

Contact the Gwinnett County Community Development Program for assistance with any questions about electronic submission of FY 2009 applications. [Telephone: 770-822-5190; Fax: 770-822-5193; TDD: 770-822-5195; email: [email protected] ].

G. DOCUMENTS TO BE SUBMITTED WITH APPLICATIONS FROM NON-PROFIT ORGANIZATIONS

Non-profit organizations must submit the items listed in Table 5 with project applications. Note: All documents must be those of the applicant organization, not those of another organization – i.e., the applicant organization’s name must appear on all the documents listed here.

If multiple applications are submitted, only one copy of each document listed in Table 5 must be submitted.

H. KEY DATES IN THE FY 2009 CDBG APPLICATION PROCESS

February 1, 2008 - Distribution of Application Notices, and Publication of Availability of Applications and announcing Application Workshops in the Gwinnett Daily Post [official legal organ of Gwinnett County].

March 25, 2008 – 1:00 P.M. & 6:00 P.M. FY 2009 Application Workshops - Gwinnett Justice and Administration Center, Conference Center, Room C, 75 Langley Drive, Lawrenceville, Georgia 30045-6900.

March 31, 2008 – Last date to receive approval of survey methodology [see page 22 – Areawide Projects]

April 18, 2008 – 5:00 P.M. – Deadline for having draft applications reviewed by Gwinnett County Community Development Program. [Appointments are required – call 770-822-5190]

April 30, 2008 – 5:00 P.M. – FY 2009 Application Submission Deadline – Gwinnett County Community Development Program Office, 575 Old Norcross Road, Suite A, Lawrenceville, Georgia 30045-4367.

Note: Organizations on the Gwinnett County Community Development Program Contact List and any other applicants for FY 2009 funds will be notified of future Public Hearings associated with FY 2009 funds, including the Proposed Action Plan 2009.

J. GWINNETT COUNTY CONSOLIDATED PLAN

All applications must address one or more of the goals and priority objectives identified in the Gwinnett County Consolidated Plan and listed here. Be certain that your application addresses the appropriate Goal(s) and Priority Objectives in the appropriate locations on each application form.

GWINNETT COUNTY CONSOLIDATED PLAN 2006-2010 GOALS AND PRIORITY OBJECTIVES

COMMUNITY DEVELOPMENT GOAL AND PRIORITY OBJECTIVES

Goal: CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased through public services activities, and providing overall program administration and management.

Priority Objectives:

Long Term Priority Objectives:

CDPFLT PUBLIC FACILITIES: To provide for the acquisition, construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

CDPSLT PUBLIC SERVICES: To provide the resources necessary to improve the community's public services, including, but not limited to, employment, crime prevention, child care, physical and mental health, drug abuse, education, energy conservation, transportation, care for the elderly, welfare and recreational needs.

CDADLT ADMINISTRATION/PLANNING/MANAGEMENT: To provide the administrative structure to conduct community development, housing, and homeless activities by planning, implementing, monitoring and evaluating, community development, housing and homeless programs.

Short Term Priority Objectives:

CDST1 To improve existing deteriorated public facilities and infrastructure in low and moderate-income areas to meet health and safety standards, including but not limited to areas of the County where the physical condition of public infrastructure and facilities need revitalization. CDST2 To construct new public facilities and infrastructure in low and moderate-income areas now lacking such facilities, including but not limited to areas of the County where the physical condition of public infrastructure and facilities need revitalization. CDST3 To construct, acquire, and/or renovate public facilities to meet the needs of special population groups such as the elderly, persons with disabilities, homeless persons, and persons suffering from various types of abuse. CDST4 To provide funding, support or technical assistance to assist in the implementation of programs for special population groups such as the elderly, persons with disabilities, homeless persons, and persons suffering from various types of abuse. CDST5 To provide funding, support, or technical assistance to private non-profit and public agencies meeting the public service needs of the County's low and moderate income population. CDST6 To encourage the development of and maximize the opportunities for minority-owned and female-owned enterprises. CDST7 To provide the administrative structure for the planning, implementation, and management of the Community Development Block Grant Program, the Emergency Shelter Grant Program, and the HOME Program/American Dream Downpayment Initiative and other housing, community development and homeless programs.

HOUSING GOALS AND PRIORITY OBJECTIVES

Goal AH: Increase Access to Affordable Housing for Low and Moderate Income Individuals, Families, and Households [AH].

AH1 Principal Reduction [downpayment and closing cost assistance] for new and first-time homebuyers AH2 Rehabilitation of existing housing for new and first-time homebuyers AH3 Homebuyer/homeowner/renter education/counseling on housing issues and housing finance (including predatory lending practices) AH4 New construction of affordable rental and homeowner housing AH5 Reduction of acquisition and development costs for affordable single-unit and multi-unit housing AH6 Encourage private and nonprofit developers with funding for acquisition, development, rehabilitation or redevelopment of affordable housing.

Goal HR: Reduce and/or Eliminate Substandard Housing for Low and Moderate Income Individuals, Families, and Households [HR]

HR1 Rehabilitate owner-occupied homes HR2 Energy conservation and weatherization improvements for homeowner and rental housing HR3 Homeowner/homebuyer/renter education and counseling on housing issues and housing finance (including predatory lending practices) HR4 Construct replacement housing where rehabilitation is not feasible HR5 Hazardous materials removal/abatement [lead/asbestos] HR6 Rehabilitation of rental housing, including acquisition of substandard units for rehabilitation

Goal SNH: Increase Housing and Supportive Services for Individuals and Families with Special Needs [SNH]

SNH1 Support the efforts of public and private non-profits to create additional housing options for special needs individuals and families SNH2 Support the efforts of public and private non-profit organizations which acquire, construct, or rehabilitate housing for persons with disabilities, including persons with HIV/AIDS and persons who are diagnosed with substance abuse and/or severe physical or mental disabilities. SNH3 Support the efforts of public and private non-profit organizations which acquire, construct or rehabilitate transitional housing, supportive housing, permanent supportive housing, or permanent housing for special needs individuals or families. SNH4 Support efforts to locate financial assistance to address the housing needs of special needs populations

HOMELESS GOAL AND PRIORITY OBJECTIVES

Goal: HML Increase Housing Options for Homeless and Near Homeless Individuals and Families

HML1 Support non-profit, private and public entities that provide housing opportunities for at-risk populations HML2 Address the emergency shelter needs of homeless persons, including individuals, families, adults, and youth HML3 Provide outreach to homeless persons for assessment of their individual needs HML4 Address the transitional housing needs of homeless persons, including families, adults, and youth HML5 Help homeless persons make the transition to permanent housing and independent living HML6 Help prevent homelessness of low-income individuals and families

Note: Any proposed project to serve the homeless must be consistent with the Gwinnett County Continuum of Care, as described in the Gwinnett County Consolidated Plan.

HUD PERFORMANCE MEASUREMENT OBJECTIVES AND OUTCOMES

Objectives:  Create Suitable Living Environments [SL]  Provide Decent Housing [DH]  Create Economic Opportunities [EO]

Outcomes:

 Availability/Accessibility [1]  Affordability [2]  Sustainability [3]

K. GENERAL APPLICATION PREPARATION GUIDANCE

1. No assurances of future year funding may be presumed as a result of any grant award from any year.

2. Applicants providing documented evidence of the availability of non-federal funds for the requested project are more likely to receive priority consideration for the approval of grant funds from Gwinnett County.

3. Use the correct type of application forms and submit the required Attachments.

Please proofread your application(s) before submission to ensure that you have completed all items in the application(s), and that all the information provided is accurate.

5. If you have any questions about application requirements or documents, make certain that you contact the Gwinnett County Community Development Program [Telephone 770-822-5190; FAX 770-822-5193; TDD 770-822-5195; email: [email protected] before submission of an application. It is recommended that draft applications be reviewed with Gwinnett County Community Development Program staff prior to submission. The deadline for having draft applications reviewed is April 18, 2008 – 5:00 P.M. Appointments are necessary for such review. Contact the Gwinnett County Community Development Program to request an application review appointment. After the submission of applications, no changes are permitted, nor may additional information be provided.

6. Please review the application requirements/documents sufficiently in advance of the submission deadline to permit you to present questions and obtain answers to your questions from the Gwinnett County Community Development Program.

7. Application preparation before the submission deadline will also permit others in your organization to review the application(s) for accuracy/completeness.

GWINNETT COUNTY COMMUNITY DEVELOPMENT BLOCK GRANT [CDBG] PROGRAM APPLICATION INSTRUCTIONS FY 2009

COMMUNITY DEVELOPMENT BLOCK GRANT [CDBG] PROGRAM

HUD EXPENDITURE REQUIREMENTS

1. Each Program Year Gwinnett County must spend at least 70% of its CDBG funds to benefit primarily low- and moderate-income persons. Each individual non-housing CDBG project must benefit primarily low and moderate-income persons [at least 51% of the persons served by each project must have total household incomes that do not exceed 80% of median household income for metropolitan Atlanta, Georgia, as depicted in the CDBG Income Table – see Attachment 3 of this Manual]. All housing activities funded with CDBG funds must serve 100% low- and moderate-income persons.

2. By October 31 of each Program Year, Gwinnett County must have expended enough of its CDBG grant funds from its Federal Letter of Credit so that not more than 1.5 times its most recent CDBG grant and any unexpended Program Income remains in the Letter of Credit.

B. ELIGIBLE AND INELIGIBLE ACTIVITIES

Applications may be submitted for a number of different eligible activities permitted under the CDBG regulations [24 CFR Part 570], and as implemented by Gwinnett County. The eligible activities are further described in the Community Development Block Grant Program Guide to National Objectives and Eligible Activities for Entitlement Communities, August, 1998. [Copies are available, at no cost, from the Gwinnett County Community Development Program.]

1. Examples of Eligible Projects [24 CFR 570.201:

a. Acquisition of real property for a CDBG-eligible activity. b. Acquisition, Construction, Reconstruction, Rehabilitation of Public Facilities and Improvements, [including equipment that is permanently affixed to the facility] c. General public facilities [excludes general government buildings such as city halls, police stations, etc.]; d. Senior Citizens Centers; e. Health Centers; f. Youth Centers; g. Centers for Persons with Disabilities; h. Parks; i. Homeless shelters; j. Battered spouse shelters; k. Streets, sidewalks, drainage, water, and sewer -- for eligible neighborhoods; l. Payment of non-federal matching shares for activities that are CDBG-eligible; m. Removal of architectural barriers in public facilities to improve accessibility by persons [adults] with disabilities; n. Public Services [Capital Equipment Only] HUD Restrictions (1) Must be a new service or an increase in current services to eligible CDBG clients; (2) Not more than 15% of the County’s CDBG funds [total of grant and program income funds] can be expended for Public Services activities by the County in a Program Year. o. Although CDBG funds may be used for economic development activities under HUD regulations, Gwinnett County does not use CDBG funds for this purpose at this time.

2. Ineligible CDBG Activities [24 CFR Part 570, Section 207]

a. Assistance used for the acquisition, construction, rehabilitation or improvements to buildings/facilities used for general conduct of government, except for the removal of architectural barriers.

b. General government expenses.

c. Political activities such as engaging in partisan political activities.

d. Operating and maintenance expenses

e. New housing construction.

C. MAXIMUM PERIOD TO COMPLETE A GWINNETT COUNTY CDBG ACTIVITY

1. 2009 Maximum Project Period - Public Facility Projects: January 1, 2009 - June 30, 2010 [18 Months]

2. 2009 Maximum Project Period - Public Services and Housing Projects: January 1, 2009 - December 31, 2009 [12 Months]

D. REIMBURSEMENTS

Funds will be available to agencies for funding by Gwinnett County on a reimbursement basis only. No funds will be advanced.

E. CONSOLIDATED PLAN

All proposed CDBG Program activities must address the Goals and Priority Objectives in the Gwinnett County Consolidated Plan and its respective Annual Action Plans [see pages 16-18], including the HUD Performance Measurement Objectives/Outcomes [see page 18].

F. WAYS TO QUALIFY A PROJECT FOR CDBG FUNDING

1. AREAWIDE PROJECTS

Projects may be qualified by defining a Project Service Area (PSA) and using Census data or door- to-door household surveys to determine if at least 51% of the beneficiaries of the proposed project will meet CDBG maximum household income limits established annually by HUD.

a. Census Data to Qualify Project Eligibility a (1) Precisely define the project service area on a clear and readable map that includes streets and roads, to enable the Gwinnett County Community Development Program staff to match the project service area with Census data for the purposes of project qualification.

(2) If you are using U.S. Bureau of the Census statistics, please provide the Census Tract and Block Group location as they relate to the Project Service Area (PSA). Contact the Gwinnett County Community Development Program staff for assistance in obtaining this information.

(3) If you need Census information for a proposed project, contact the Gwinnett County Community Development Program Office as early as possible.

b. Surveys to Qualify Project Eligibility

b (1) If you need to use a survey to qualify your proposed project, contact the Community Development Program by March 31, 2008 for survey methodology guidance.

(2) The HUD-approved survey form is presented as Attachment 5 of this Manual. Use this form for applications submitted in the competition cycle. Copies of each survey form must be submitted with the application, with a summary compilation of all surveys collected.

(3) Survey methodologies that have not been approved by the U.S. Department of Housing and Urban Development are not acceptable to qualify a project for CDBG funding.

(4) If you are using special survey data, attach to your application a detailed explanation of your survey methodology, a copy of each survey form and a copy of any summary documents that were used to compile the results of the survey.

(5) Failure to contact the Gwinnett County Community Development Program Office prior to performing a survey can result in the disqualification of your project from competition due to the use of an unapproved survey methodology.

2. LIMITED CLIENTELE PROJECTS

Limited clientele projects can consist of two types: (1) Direct Service Projects; or (2) Presumed Benefit Projects:

a. Direct Service Projects

A CDBG project can be qualified for eligibility by calculating and verifying the total combined income of all residents of each of the households that will benefit from the project.

b. Presumed Benefit Projects

c Presumed Benefit projects serve special population groups:

(1) Abused children (2) Elderly persons [Age 62 or older] (3) Battered spouses (4) Homeless persons (5) Disabled Adults [Census Definition of Severely Disabled Adult*] (6) Illiterate persons (7) Persons living with AIDS (8) Migrant farm workers

Projects serving these groups of people qualify as benefiting 100% low and moderate- income persons, unless HUD has reason to believe that the individuals served represent households with income levels higher than 80% of Median Household Income.

*The Census Definition of Severely Disabled is: Persons are classified as having a severe disability if they: (a) used a wheel chair or had used another special aid for six months or longer; (b) are unable to perform one or more "functional activities" or need assistance with an "ADL or IADL"; (c) are prevented from working at a job or doing housework; or (d) have a selected condition including autism, cerebral palsy, Alzheimer's disease, senility or dementia, or mental retardation. Also, persons who are under 65 years of age and who are covered by Medicare or who receive SSI are considered to have a severe disability.

G. REAL PROPERTY ACQUISITION OR EASEMENTS

If your organization is proposing to use CDBG funds to acquire real property or obtain easements, please contact the Gwinnett County Community Development Program prior to submitting the application. This process will ensure you are aware of the acquisition, relocation, and displacement requirements of the Community Development Block Grant Program.

H. FLOODPLAIN/FLOOD-PRONE, HISTORIC, ENVIRONMENTAL AND TOXIC HAZARDS

Contact the Gwinnett County Community Development Program for information or guidance if you need to know if the site of your proposed project:

1. Is located in a Federally-designated Floodplain or flood-prone area; 2. Is located in or adjacent to a designated Historic District; 3. Is a designated Historic site or property; 4. Is eligible for designation as an Historic site or property; 5. May possess potential environmental hazards or toxic substances.

I. OTHER CDBG APPLICATION PREPARATION GUIDANCE

1. For CDBG applications, submit the following items: a. Application – Part I; b. Application – Part II – Items 1-3, and applicable other pages; c. Application - Attachment 1; d. Attached documents submitted by applicant to support its request(s); e. Required submission attachments for non-profit organizations [See Table 5, Page 14].

2. Generally, these organizations use the following application forms. However, applicants must choose the correct application form to use, based on their own needs. Contact the Gwinnett County Community Development Program if you have questions about what forms to use.

a. Non-Profit Organizations

(1) Part I [Required] (2) Part II, Items 1-3 [Required] (3) Part II, Part 4 [Any of the following]: (a) Public Facilities 4A New Construction D:\Docs\2018-04-07\0e78c4d853f45fd59aaf2fde95c53f6f.doc HUD Grant Application Manual - Gwinnett County, Georgia - FFY 2009 - CDBG Program Application Page 28

4B Renovation

(b) Public Services 4Q Transportation Equipment 4R Health Services Equipment 4S Recreation Equipment 4T Computer Equipment 4U Audio-Visual Equipment 4V Other Equipment

(c) Housing Counseling 4W Housing Counseling for Homebuyers

(d) Fair Housing 4X Fair Housing Activities

(4) Attachment 1 [Required]

b. County Departments/Participating Cities/Housing Authorities

(1) Part I [Required] (2) Part II, Items 1-3 [Required]

(3) Part II, Part 4 [Any of the following]:

(a) Public Facilities 4A New Construction 4B Renovation 4C Water Projects (New) 4D Water Projects (Reconstruction) 4E Sewer Projects (New) 4F Sewer Projects (Reconstruction) 4G Drainage Projects (New) 4H Drainage Projects (Reconstruction) 4I Curb/Gutter Projects (New) 4J Curb/Gutter Projects (Reconstruction) 4K Street Projects (New) 4L Street Projects (Reconstruction) 4M Sidewalk Projects (New) 4N Sidewalk Projects (Replacement) 4O Park Projects (New) 4P Park Projects (Reconstruction)

(b) Public Services 4Q Transportation Equipment 4R Health Services Equipment 4S Recreation Equipment 4T Computer Equipment 4U Audio-Visual Equipment 4V Other Equipment

(4) Attachment 1 [Required]

3. At least 51% of the persons to be served with non-housing CDBG-assisted projects must have total household income that does not exceed the federally established maximum income limits. [See Attachment 3 for the CDBG Maximum Income Limits at the time this application manual was released]. Housing applications must serve 100% low- and moderate- income persons, using the same CDBG Maximum Income Limits in Attachment 3.

4. Give specific project name, location and details, including an exact street address for the project site. For example, if your agency proposes a water line replacement in a low- income neighborhood, list the street where the water line will be replaced, the total number of linear feet and size of the water line, and the beginning and ending points. [Install 1,500 L.F. of 8" PVC water line on Smith Street from Brown Drive to White Circle."]

5. Take enough time to provide Gwinnett County with sufficient information about your proposed project to permit independent site inspections by the Gwinnett County Community Development Program staff.

6. Identify clearly the project, its purpose and scope, to enable the reviewer to quickly understand the proposed project. Provide explicit maps, photographs, blueprints, etc. with your application to permit careful and complete evaluation of the proposal.

7. Missing and/or insufficient data will reduce the competitiveness of an otherwise eligible proposed project.

8. Allow sufficient time to complete all of the requested information. Failure to do so may jeopardize the funding of your project.

9. Monthly reports are required for "Limited Clientele" activities to document that the projects are accomplishing the goals you established in your application.

10. Failure to continue the eligible activity for which CDBG funds are awarded may result in the applicant being required to repay the funds to Gwinnett County and/or the United States Government from the organization’s non-Federal funds.

11. Organizations that document in their application(s) the use of additional funding resources for the project for which they are requesting CDBG funds, other than the requested CDBG funds, will increase their probability of receiving CDBG funds from Gwinnett County.

12. Questions concerning application procedures or project eligibility may be posed until April 30, 2008, 5:00 P.M. to: Gwinnett County Community Development Program at 770-822-5190; TDD 770-822-5195; FAX 770-822-5193; TDD 770-822-5195; email: [email protected] .

GWINNETT COUNTY HUD ENTITLEMENT GRANTS FY 2009 APPLICATION FORMS

PART I

SUBMIT SEPARATE PART I FORMS FOR EACH GRANT [CDBG/HOME/ADDI/ESG] SUBMITTED

--SUBMIT ONLY 1 - PART I FORM FOR ALL CDBG APPLICATIONS-- --SUBMIT ONLY 1 - PART I FORM FOR ALL HOME/ADDI APPLICATIONS------SUBMIT ONLY 1 - PART I FORM FOR ALL ESG APPLICATIONS------SUBMIT DOCUMENT SUBMISSION CHECKLIST FOR ALL GRANTS--

D:\Docs\2018-04-07\0e78c4d853f45fd59aaf2fde95c53f6f.doc HUD Grant Application Manual - Gwinnett County, Georgia - FFY 2009 - CDBG Program Application Page 32 Form: GCD001S - Date 01/08

GWINNETT COUNTY, GEORGIA GRANT APPLICATION - CDBG/HOME/ADDI/ESG PROGRAMS - FFY 2009 PART I - COMPLETE/SUBMIT FOR ALL GRANT APPLICATIONS

Application Receipt Date/Time/ ------ Reserved for Gwinnett County Use Only

1. Applicant Name ------ (Agency or Organization) 2. Applicant Agency Mailing Address------ 3. City------ 4. State------ 5. Zip + Four------ 6. Contact Person------ 7. Contact Person Title------ 8. Telephone Number ------ [Include Area Code] 9. FAX Number------ [Include Area Code] 10 Email Address of Contact Person------ 11. Website Address [If Applicant Has A Website] 12. Date of Incorporation [If Non-Profit]------ 13. Fed. ID Nos:------ FEI # [Example 58-111111] DUNS # 14. Non-Profit Organization Current Total Budget $ 15. Non-Profit Organization Current Budget % Government Funds 16. Non-Profit Organization Current Budget % Private Funds 17. Grant Program For Which This Application Is Note: Separate Applications Must be Submitted for Each Grant Submitted [Use Separate Part I Forms for Program Each Grant with Original Signatures on Each] A. CDBG -[CFDA No. 14-218]------ Check B. HOME/ADDI -[CFDA No. 14-239]------ [Not Applicable to This Application] C. ESG --[CFDA No. 14-231]------ [Not Applicable to This Application] 18. Application Signatures/Dates A. Typed Name - Prepared Application ---- B. Signature – Application Preparer------ C. Date of Preparer Signature ------

D. Typed Name - Application Approval---- E. Signature - Approving Application------ F. Date of Approving Signature------ Note: Persons Signing Applications Must Have Please Attach Documentation Indicating The Approval of Your Received Authority to Take Such Actions from Organization’s Governing Body Authorizing the Submission of the the Governing Board of the Organization Attached Application. Submitting the Application.

GWINNETT COUNTY –HUD ENTITLEMENT GRANTS COMPETITION FY 2009 PART I APPLICATION SUBMISSION CHECKLIST

SUBMIT WITH ALL APPLICATION[S] TO GWINNETT COUNTY.

Check for Each Item Submitted TABLE 1 SUBMISSIONS FOR ALL GRANTS Submission Part I Part II Attachment Attachment Non-Profit CDBG HOME/ADDI ESG Type W/Original Section 4 1 2 Organization Application Application Application Signatures [Appropriate [Quantity] [Quantity] Attachments Check Check Check [Quantity] Pages] [See Table 2] [Either [Either [Either [Quantity] [Quantity] Hardcopy or Hardcopy or Hardcopy Electronic] Electronic] or Electronic] Hardcopy 1 2 2 2 1 N/A N/A Electronic 1 1 1 1 1 N/A N/A

Additional required hardcopy documents to be submitted by Non-Profit Organizations are depicted in Table 2.

TABLE 2 HARDCOPY ATTACHMENTS - NON-PROFIT ORGANIZATIONS [One Copy of Each Covers All Applications Submitted] [All Documents Must Bear the Name of the Applicant Organization] Check Attachment [Quantity] For Each Item Submitted Current tax-exempt certification [Section 501(c)(3)], that it has received from the IRS 1 prior to submission of the application. If the organization has requested tax- exempt status from the IRS, but the 501(c)(3) certification has not been received at the time of application submission, the organization will not be eligible for competition during this funding cycle. Incorporation approval and evidence of current good standing from the Georgia 1 Secretary of State [Current status available online from http://www.sos.state.ga.us/corporations/corpsearch.htm Current by-laws 1 Listing of current officers and current members of the Board of Directors, and their 1 home addresses, not the applicant organization’s address . Most recent audit or audited financial statement of the organization submitting the 1 application to Gwinnett County. The audit or audited financial statement must be prepared and signed by an independent auditor. The document must indicate to Gwinnett County that the organization has the fiscal capacity to carry out the project submitted for funding and a system of internal controls to protect the investment of HUD grant funds. Most recent IRS Form 990 or 990 EZ [Return of Organization Exempt from Income 1 Tax] Applicant must submit a copy of their organization’s most recent submission of Form 990 or 990 EZ, and all schedules and attachments, to the Internal Revenue Service. Form 990 or 990EZ are required under section 501(c) of the Internal Revenue Code. Current Business Plan. The Business Plan is an indication to Gwinnett County how the 1 organization carries out strategic planning, its evaluation of performance, and its capacity to successfully carry out its proposed HUD grant project(s).

REMINDER: THIS CHECKLIST MUST BE SUBMITTED WITH YOUR ORGANIZATION’S APPLICATION(S) TO GWINNETT COUNTY.

GWINNETT COUNTY HUD ENTITLEMENT GRANTS APPLICATION FORMS FY 2009

PART II

SUBMIT FOR CDBG APPLICATIONS ONLY

SUBMIT SEPARATE PAGES 1 & 2 [ITEMS 1-3] OF PART II FOR EACH SEPARATE CDBG ACTIVITY

SUBMIT OTHER PART II PAGES, AS APPROPRIATE TO THE TYPE (S) OF APPLICATION (S) SUBMITTED

SUBMIT ATTACHMENT 1 [NARRATIVE DESCRIPTIONS] FOR EACH SEPARATE CDBG ACTIVITY SUBMITTED

IF APPLICANT IS A NON-PROFIT ORGANIZATION  SUBMIT  [ALL DOCUMENTS MUST BE FOR THE APPLICANT ORGANIZATION]  TAX EXEMPT CERTIFICATION FROM IRS - 501(c)(3)  INCORPORATION APPROVAL & EVIDENCE OF CURRENT GOOD STANDING WITH GEORGIA SEC. OF STATE  CURRENT BY-LAWS  CURRENT OFFICERS WITH ADDRESSES  CURRENT BOARD OF DIRECTORS WITH ADDRESSES  MOST RECENT AUDIT OR AUDITED FINANCIAL STATEMENT  MOST RECENT 990/990 EZ & SCHEDULES/ATTACHMENTS FILED W/IRS  BUSINESS PLAN

Form: GCD002 Form: Date 01/08

GWINNETT COUNTY, GEORGIA GRANT APPLICATION - CDBG PROGRAM - FFY 2009 PART II - COMPLETE/SUBMIT FOR ALL CDBG APPLICATIONS

PART II – PAGE 1 - SUBMIT SEPARATE PAGES 1 & 2 OF THIS PART FOR EACH CDBG APPLICATION 1. Map with Project Service Area Boundaries [Select A or B] A. PSA Map Attached [Select 1 or 2]------ Check 1. PSA on Map is smaller than Countywide ------ Check 2. PSA is Countywide------ Check 2. Project Eligibility Type [Select A or B] A. Areawide Projects [Select Census Data (1) or Survey Methodology (2)] (1) Census Data------ Check Attach Data & Source to Document Census Tracts/Block Groups. (2) PSA Survey Check ------ Only HUD approved Survey Questionnaire formats may be used to qualify a project. The survey form is contained in Attachment 5 of this Manual. Contact the Gwinnett County Community Development Program for instructions on using the survey form. After obtaining survey form use instructions and completing the survey process, complete the summary data from the analysis of all surveys. All surveys must be performed before submitting this application. Copies of all completed survey forms must be submitted with the application. If the surveys are not submitted with the application, the application will be considered incomplete and returned to the applicant. (a) PSA Summary (i) Total # of Homes or Apts. in PSA------ [ ] (ii) Total # of Homes or Apts. Surveyed in PSA------ [ ] (iii) Total # of persons in PSA------ [ ] (iv) Total # low/moderate income persons in PSA------ [ ] (v) Percentage of low/moderate persons in PSA------ [ ] B. Limited Clientele Projects (1) Direct Service [Qualify Individuals on Income] or------ Check OR (2) Presumed Benefit ------ Check [Qualify individuals as members of presumed benefit groups. Select ONLY ONE of the groups listed below. [See definitions on pages 9 & 23 of the CDBG Application Manual] (a) Abused Spouses------ Check OR (b) Elderly Persons [Age 62 and older]------ Check OR (c) Abused/Neglected Children------ Check OR (d) Homeless Persons------ Check OR (e) Disabled Adults - [Severely Disabled Per Census]------ Check OR (f) Illiterate Persons------ Check OR (g) Person Living with AIDS------ Check OR (h) Migrant Farm Workers------ Check

PART II – PAGE 2- SUBMIT SEPARATE PAGES 1 & 2 OF THIS PART FOR EACH CDBG APPLICATION 3. Environmental/Historical/Accessibility CDBG Application A. Application Is Seeking Public Services Funds? Check - Yes No - If “Yes” is checked, skip items 3B- 3G on this page, and go to pages 66-77 for eligible Public Services activities. If “No” is checked, complete items 3B- 3G on this page, then select from pages 33-65 for appropriate Public Facilities and Infrastructure activities. B. Age of Structure - [If Acquisition or Renovation]----- Estimated Year of Construction: [ ] C. Building Tested for Hazardous Materials (1) Lead-Based Paint------ Check - Yes No Unknown (2) Asbestos------ Check - Yes No Unknown D. Hazardous Materials Removed from Site/Building---- Check - Yes No Unknown E. CDBG Funds Requested in this Application for Check - Yes No -Removal or abatement of hazardous materials. [Describe in Attachment 1.]------ F. Hazardous Materials Removal Budget Estimate------ CDBG: $ Applicant: $ Other: $ Total: $ G. Environmental/Historical Site Factors (1) Is/was project site a location for current or former Check - Yes No Unknown underground fuel or chemical storage tanks or containers? ------ (2) Is/was project site a location for current or former Check - Yes No Unknown gasoline service station?------ (3) Is/was project site a location for current or former Check - Yes No Unknown bulk gasoline/oil dealer/chemical sales/storage/herbicide/pesticide manufacturing or storage/wood treatment [creosote, etc.] facility? --- (4) Is/was project site a location for current or former Check - Yes No Unknown dry cleaners? ------ (5) Is/was project site a location for current or former Check - Yes No Unknown Landfill or hazardous waste disposal site/facility?- (6) Is/was project site adjacent to any of the types of Check - Yes No Unknown sites/facilities listed in G (1)-(5)? ------ (7) Is the site located in a designated Historic District?-> Check - Yes No (8) Is the site adjacent to a designated Historic District?> Check - Yes No (9) Historic District located on Attached Map? ------ Check - Yes No (10) Will proposed project affect an historic Check - Yes No structure/property designated or eligible for designation on the National Register of Historic Places? ------ (11) Historic structure/property located on Attached Check - Yes No Map? ------ (12) Is proposed project site located in a Federally Check - Yes No designated floodplain? ------ If yes, indicate in an attached narrative how project will avoid encroachment into the floodplain. (13) Is the proposed project site located in or contains a Check - Yes No wetlands, as defined by the U.S. Army Corps of If yes, indicate in Attachment 1 how the project will avoid Engineers or as identified by local government or encroachment into the wetlands. engineering professionals? ------ (14) Is the proposed project site adjacent to a major Check - Yes No airport, highway, or railroad facility? ------ If yes, describe in Attachment 1 how the impacts of these facilities on the project will be ameliorated.

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES A. Building Construction – Public Facility (1) Does Applicant Own Project Site? Check - Yes No (2) If Applicant does not own the project site, does Check - Yes No the applicant intend to purchase the property utilizing CDBG funds requested in this Purchase Price for Site: $ application and/or applicant’s funds? [CDBG funds may be used to pay only the “Fair Market” CDBG Funds Applicant Funds Total Value for real property, as determined by an Appraisal $ $ $ prepared by a licensed Georgia Real Estate Appraiser.] (3)New Construction Budget CDBG Funds Applicant Funds Total Design Services [Architect/Engineer] $ $ $ Construction Supervision [Architect/Engineer] $ $ $ Site Preparation $ $ $ Construction Costs [Labor] $ $ $ Construction Costs [Materials] $ $ $ Total Construction Budget $ $ $

(4) Provide a description of the proposed project. Project Description: [Provide a more complete description in Attachment 1.]

------ (5) Gwinnett County Consolidated Plan Goal(s) Goal(s) Addressed by the Proposed Project [See Page CD Increase the capacity of public facilities and public services to improve the 16 of this Manual] social, economic, and physical environment for low- and moderate-income individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (6A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. [See Page 16 of this Manual] Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

Short Term: Check One or More, As Applicable ------ CDST1 To improve existing, deteriorated public facilities and infrastructure in low and moderate-income areas to meet health and safety standards, including but not limited to areas of the County where the physical condition of public infrastructure and facilities need revitalization.

CDST2 To construct new public facilities and infrastructure in low and moderate-income areas now lacking such facilities, including but not limited to areas of the County where the physical condition of public infrastructure and facilities need revitalization.

CDST3 To construct, acquire, and/or renovate public facilities to meet the needs of special population groups such as the elderly, persons with disabilities, homeless persons, and persons suffering from various types of abuse.

CDST6 To encourage the development of and maximize the opportunities for minority-owned and female-owned enterprises.

(6B) HUD Performance Measures Select One Objective: Select One Outcome

------ Create Suitable Living Environments [SL] Availability/Accessibility [1] Provide Decent Housing [DH] Affordability [2] Create Economic Opportunities [EO] Sustainability [3]

(7) Applicant Project Priorities – CDBG This Project is Priority # [ ] of [ ] CDBG Projects

A. Building Construction – Public Facility – P. 2 (8) Project Location A. Street Address------ B. City------

C. State------ D. Zip Code------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the Check Here If Map Attached: proposed project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (9) Total Persons To Be Served by Proposed Project Total Number: [ ] (10) Number of Low and Moderate Income Persons Number Low/Moderate Income: [ ] To Be Served by Proposed Project (11) Percentage of Low and Moderate Income Percentage Low/Moderate Income: [ ] % Persons To Be Served by Proposed Project [Divide the number entered for Item 10 by the number entered for Item 9]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds.

[See Income Tables in Attachment 3 for Definitions and Income Limits] If Proposed Project is a Presumed Benefit Project Complete Items 12 - 19, as Appropriate (12) Number of Elderly Persons [Age 62 and older] [ ] to be Served by Proposed Project, or (13) Number of Adults with Severe Disabilities to [ ] be Served [As defined by U.S. Census – See Page 9], or (14) Number of Battered Spouses to be Served, or [ ] (15) Number of Abused Children to be Served, or [ ] (16) Number of Persons Living with AIDS to be [ ] Served, or (17) Number of Homeless Persons to be Served, or [ ] (18) Number of Illiterate Persons to be Served, or [ ] (19) Number of Migrant Farm Workers to be Served [ ] (20) Number of Female-Headed Households to be [ ] Served (21) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES B. Building Renovation – Public Facility (1) Does Applicant Own Facility to be renovated?- Check -Yes No (2) If Applicant Does Not Own the Facility, Does Check -Yes No Applicant Propose to Lease Property [HUD Copy of Proposed Lease Attached: Requires Minimum Lease Period of 15 Year]?- Check -Yes No (3) Year of construction of facility/building to be Year of Construction [ ] renovated------ (4) Is the facility/building currently designated or Check -Yes No eligible for designation on the National Register If yes, locate on attached map(s) of Historic Places?------ (5) Has facility/building been tested for lead-based Check -Yes No paint?------ (6) Has facility/building been tested for asbestos? Check -Yes No (7) Renovation Budget CDBG Funds Applicant Funds Total Design Services [Architect/Engineer] $ $ $ Construction Supervision [Architect/Engineer] $ $ $ Renovation Costs $ $ $ Total Renovation Budget $ $ $ Note: Include Accessibility Improvements in this OR budget if other renovation is proposed. If only Budget is for Accessibility Improvements Only Check accessibility improvements are proposed, skip this item, and complete Item 14. and complete the Item 13 budget section. (8) Provide a description of the proposed project. Project Description: [Provide a more complete description in Attachment 1.] ------ (9) Gwinnett County Consolidated Plan Goal(s) Goal(s) Addressed by the Proposed Project. [See Page CD Increase the capacity of public facilities and public services to improve the 16 of this Manual] social, economic, and physical environment for low- and moderate-income individuals and families by acquiring, constructing, or rehabilitating public ------ facilities, revitalizing older areas of the County, providing equipment purchased through public services activities, and providing overall program administration and management. (10) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. [See Page 16 of this Manual] Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade ------ and maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

Short Term: Check One or More, As Applicable

CDST1 To improve existing, deteriorated public facilities and infrastructure in low and moderate-income areas to meet health and safety standards, including but not limited to areas of the County where the physical condition of public infrastructure and facilities need revitalization.

B. Building Renovation – Public Facility – P. 2 (11) HUD Performance Measures Select One Objective: Select One Outcome

(13) Facility Accessible to Persons w/Disabilities Check -Yes No Unknown

(14) Facility Accessible to Persons w/Disabilities Check -Yes No Unknown

(15) CDBG Funds Requested in this Application to Check -Yes No make accessibility improvements, only If Yes, Describe in Attachment 1. (16) Accessibility Improvements Budget Estimate CDBG Funds Applicant Funds Total Design Services [Architect/Engineer] $ $ $ Construction Supervision [Architect/Engineer] $ $ $ Renovation Costs $ $ $ Total Renovation Accessibility Budget $ $ $

Note: If only accessibility improvements are OR proposed, complete this item. If the overall renovation includes Accessibility Improvements Budget is for Accessibility Improvements as a part of overall skip this item and complete item 7 of this form. renovation Check and complete the Item 7 budget section. (17) Briefly describe the proposed Accessibility Project Description: [Provide a more complete description in Improvements in the block to the right. Attachment 1.] Provide a more detailed explanation on Attachment 1. ------ (18) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the Check Here If Map Attached: proposed project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (19) Total Persons To Be Served by Proposed Total Number: [ ] Project------ (20) Number of Low and Moderate Income Persons Number Low/Moderate Income: [ ] To Be Served by Proposed Project------ (21) Percentage of Low and Moderate Income Percentage Low/Moderate Income: [ ]% Persons To Be Served by Proposed Project [Divide the number entered for Item 20 by the number entered for Item 19]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds.

[See Income Table in Attachment 3 for Definitions and Income Limits]

B. Building Renovation – Public Facility – P. 3 If Proposed Project is a Presumed Benefit Project Complete Items 22-29, below, as Appropriate (22) Number of Elderly Persons [Age 62 and older] [ ] to be Served by Proposed Project, or (23) Number of Adults with Severe Disabilities to be [ ] Served [As defined by U.S. Census - See Page 9], or (24) Number of Battered Spouses to be Served, or, [ ] (25) Number of Abused Children to be Served, or [ ] (26) Number of Persons Living with AIDS to be [ ] Served, or (27) Number of Homeless Persons to be Served, or [ ] (28) Number of Illiterate Persons to be Served, or, [ ] (29) Number of Migrant Farm Workers to be Served [ ] (30) Number of Female-Headed Households to be [ ] Served (31) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES C. Water Projects [New] – Public Facility (1) Name of Street(s) where project is proposed------ [Street Name(s)]: (2) Water Line Description------ Linear Feet of Line to Be Installed: [ ] Diameter of Line to Be Installed: [ ]

(3) New Water Lines to be installed from: Beginning Point Street Name: [Name of Street(s)]------ (4) New Water Lines to be installed to: Ending Point Street Name: [Name of Street(s)]------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map.------ Check -Yes No

(6) Water Project [New] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Water [New] Budget $ $ $ (7) Provide a description of the proposed project Project Description: [Provide a more complete description in Attachment 1.] ------ (8) Gwinnett County Consolidated Plan Goal(s) Goal(s) Addressed by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income individuals and [See Page 16 of this Manual] families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased through public services ------ activities, and providing overall program administration and management. (9A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and ------ maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

CDST2 To construct new public facilities and infrastructure in low and moderate- income areas now lacking such facilities, including but not limited to areas of the County where the physical condition of public infrastructure and facilities need revitalization.

C. Water Projects [New] – Public Facility – Page 2 (11) Project Location A. Street Address------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide ------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (12) Total Persons To Be Served by Proposed Project Total Number: [ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds.

[See Income Table in Attachment 3 for Definitions and Income Limits] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES D. Water Projects [Reconstruction] – Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]:

------ (2) Water Line Description Linear Feet of Line to Be Reconstructed: [ ] ------ Diameter of Line to Be Reconstructed: [ ]

(3) Water Lines to be installed from: Beginning Point Street Name: [Name of Street(s)] ------ (4) Water Lines to be installed to: Ending Point Street Name [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated the attached map. Check -Yes No (6) Water Project [Reconstruction] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Water [Reconstruction] Budget $ $ $ (7) Provide a description of the proposed project Project Description: [Provide a more complete description in Attachment 1.] ------ (8) Gwinnett County Consolidated Plan Goal(s) Goal(s) Addressed by the Proposed Project. [See Page 16 of CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (9A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and ------ maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

CDST2 To construct new public facilities and infrastructure in low and moderate-income areas now lacking such facilities.

D. Water Projects [Reconstruction] – Public Facility Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide ------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (12) Total Persons To Be Served by Proposed Project Total Number: [ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES E. Sewer Projects [New] – Public Facility (1) Name of Street(s) where project is proposed------ [Street Name(s)]: (2) Sewer Line Description------ Linear Feet of Line to Be Installed: [ ] Diameter of Line to Be Installed: [ ]

(3) New Sewer Lines to be installed from: Beginning Point Street Name: [Name of Street(s)]------ (4) New Sewer Lines to be installed to: Ending Point Street Name: [Name of Street(s)]------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map.------ Check -Yes No (6) Sewer Project [New] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Sewer [New] Budget $ $ $ (7) Provide a description of the proposed project Project Description: [Provide a more detailed explanation on Attachment 1.]

------

(8) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (9A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and ------ maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

CDST1 To improve existing, deteriorated public facilities and infrastructure in low and moderate-income areas to meet health and safety standards, including but not limited to areas of the County where the physical condition of public infrastructure and facilities need revitalization...

E. Sewer Projects [New] – Public Facility – Page 2 (11) Project Location A. Street Address------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide ------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (12) Total Persons To Be Served by Proposed Project Total Number: [ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds.

[See Income Table in Attachment 3 for Definitions and Income Limits] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES F. Sewer Projects [Reconstruction] – Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]: ------ (2) Sewer Line Description Linear Feet of Line to Be Reconstructed: [ ] ------ Diameter of Line to Be Reconstructed: [ ]

(3) Sewer Lines to be installed from: Beginning Point Street Name: [Name of Street(s)] ------ (4) Sewer Lines to be installed to: Ending Point Street Name [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map. Check -Yes No (6) Sewer Project [Reconstruction] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Sewer [Reconstruction] Budget $ $ $ (7) Provide a description of the proposed project. Provide Project Description: [Provide a more detailed explanation on a more complete description in Attachment 1. Attachment 1.]

------ (8) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (9A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and ------ maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

CDST6 To encourage the development of and maximize the opportunities for minority-owned and female-owned enterprises. (9B) HUD Performance Measures Select One Objective: Select One Outcome

F. Sewer Projects [Reconstruction] – Public Facility - Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide ------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (12) Total Persons To Be Served by Proposed Project Total Number: [ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES G. Drainage Projects [New] – Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]: ------ (2) Drainage Construction Description Linear Feet to Be Installed: [ ] ------ (3) New Drainage Construction to be installed from: Street Name: Beginning Point [Name of Street(s)] ------ (4) New Drainage Construction to be installed to: Street Name: Ending Point [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map. Check -Yes No (6) Drainage Project [New] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Drainage [New] Budget $ $ $ (7) Provide a description of the proposed project. Project Description: [Provide a more detailed explanation on Attachment 1.]

G. Drainage Projects [New] – Public Facility - Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide ------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (12) Total Persons To Be Served by Proposed Project Total Number:[ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income:[ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES H. Drainage Projects [Reconstruction] – Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]: ------ (2) Drainage Reconstruction Description Linear Feet to Be Reconstructed: [ ] ------ (3) Drainage Reconstruction to be installed from: Street Name: Beginning Point [Name of Street(s)] ------ (4) Drainage Reconstruction to be installed to: Street Name: Ending Point [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated the attached map. ------ Check -Yes No

(6) Drainage Project [Reconstruction] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Drainage [Reconstruction] Budget $ $ $ (7) Provide a description of the proposed project Project Description: [Provide a more detailed explanation on Attachment 1.] ------ (8) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (9A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Pages 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and ------ maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

H. Drainage Projects [Reconstruction] – Public Facility Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide ------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition. (12) Total Persons To Be Served by Proposed Project Total Number:[ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES I. Curb/Gutter Projects [New] – Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]: ------ (2) Curb/Gutter Construction Description Linear Feet to Be Installed: [ ] ------ (3) New Curb/Gutter to be installed from: Street Name: Beginning Point [Name of Street(s)] ------ (4) New Curb/Gutter to be installed to: Street Name: Ending Point [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map. Check -Yes No (6) Curb/Gutter Project [New] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Curb/Gutter [New] Budget $ $ $ (7) Provide a description of the proposed project. Project Description: [Provide a more detailed explanation on Attachment 1.]

------ (8) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (9A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and maintain the viability of neighborhoods where low and moderate-income families ------ reside; and, (3) revitalize older areas of the County. Short Term: Check One or More, As Applicable

I. Curb/Gutter Projects [New] – Public Facility Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition. (12) Total Persons To Be Served by Proposed Project Total Number: [ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limit.] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES J. Curb/Gutter Projects [Reconstruction] – Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]: ------ (2) Curb/Gutter Reconstruction Description Linear Feet to Be Reconstructed: [ ] ------ (3) Curb/Gutter Reconstruction to be installed from: Street Name: Beginning Point [Name of Street(s)] ------ (4) Curb/Gutter Reconstruction to be installed to: Street Name: Ending Point [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map. Check -Yes No (6) Curb/Gutter Project [Reconstruction] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Curb/Gutter [Reconstruction] Budget $ $ $ (7) Provide a description of the proposed project. Project Description: [Provide a more detailed explanation on Attachment 1.] ------

(8) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (9A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and maintain the viability of neighborhoods where low and moderate-income families ------ reside; and, (3) revitalize older areas of the County. Short Term: Check One or More, As Applicable

J. Curb/Gutter Projects [Reconstruction] – Public Facility - Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: Check project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition. (12) Total Persons To Be Served by Proposed Project Total Number: [ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income:[ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income:[ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES K. Street Projects [New]– Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]: ------ (2) Street Construction [New] Description Linear Feet of Street to Be Paved: [ ] ------ Width of Street to Be Paved: [ ] (3) Paving to be installed from: Beginning Point Street Name: [Name of Street(s)] ------ (4) Paving to be installed to: Ending Point Street Name: [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map. Check -Yes No (6) Street Project [New] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Streetlight Installation $ $ $ Total Street [New] Budget $ $ $ (7) Provide a description of the proposed project. Project Description: [Provide a more detailed explanation on Attachment 1.] ------ (8) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased through public ------ services activities, and providing overall program administration and management. (9A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and ------ maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

CDST2 To construct new public facilities and infrastructure in low and moderate- income areas now lacking such facilities, including but not limited to areas of the County where the physical condition of public infrastructure and facilities need revitalization.

K. Street Projects [New] – Public Facility - Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (12) Total Persons To Be Served by Proposed Project Total Number: [ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES L. Street Projects [Reconstruction]– Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]: ------ (2) Street Reconstruction Description Linear Feet of Street to Be Reconstructed: [ ] ------ Width of Street to Be Reconstructed: [ ] (3) Reconstruction from: Beginning Point Street Name: [Name of Street(s)] ------ (4) Reconstruction to: Ending Point Street Name: [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map. Check -Yes No (6) Street Project [Reconstruction] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Streetlight Installation $ $ $ Total Street [Reconstruction] Budget $ $ $ (7) Provide a description of the proposed project. Project Description: [Provide a more detailed explanation on Attachment 1.]

L. Street Projects [Reconstruction] – Public Facility Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached - Failure to Submit Map Will Check Here If Map Attached: Make Project Ineligible for Competition (12) Total Persons To Be Served by Proposed Project Total Number: [ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES M. Sidewalk Projects [New] – Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]: ------ (2) Sidewalk Construction [New] Description Linear Feet of Sidewalk to Be Paved: [ ] [MUST USE ADA SPECIFICATIONS] Width of Sidewalk to Be Paved: [ ]

(3) Sidewalk to be installed from: Beginning Point Street Name: [Name of Street(s)] ------ (4) Sidewalk to be installed to: Ending Point Street Name: [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map. Check -Yes No (6) Sidewalk Project [New] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Sidewalk [New] Budget $ $ $ (7) Provide a description of the proposed project. Project Description: [Provide a more detailed explanation on Attachment 1.]

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(8) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (9A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and ------ maintain the viability of neighborhoods where low and moderate-income families reside; and, (3) revitalize older areas of the County.

--0------ Create Suitable Living Environments [SL] Availability/Accessibility [1] Provide Decent Housing [DH] Affordability [2] Create Economic Opportunities [EO] Sustainability [3]

M. Sidewalk Projects [New] – Public Facility - Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (12) Total Persons To Be Served by Proposed Project Total Number:[ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES N. Sidewalk Projects [Reconstruction] – Public Facility (1) Name of Street(s) where project is proposed [Street Name(s)]: ------ (2) Sidewalk Reconstruction Description Linear Feet of sidewalk to Be Reconstructed: [ ] [MUST USE ADA SPECIFICATIONS] Width of Sidewalk to Be Reconstructed: [ ] (3) Reconstruction from: Beginning Point Street Name: [Name of Street(s)] ------ (4) Reconstruction to: Ending Point Street Name: [Name of Street(s)] ------ (5) Depict the proposed beginning/ending points on Map Attached with beginning/ending points indicated attached map. Check -Yes No (6) Sidewalk Project [Reconstruction] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Sidewalk [Reconstruction] Budget $ $ $ (7) Provide a description of the proposed project. Project Description: [Provide a more detailed explanation on Attachment 1.]

N. Sidewalk Projects [Reconstruction] – Public Facility - Page 2 (11) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (12) Total Persons To Be Served by Proposed Project Total Number: [ ] (13) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income:[ ] Served by Proposed Project (14) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 13 by the number entered for Item 12]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits (15) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES O. Parks Projects [New]– Public Facility (1) Park Location [Name of Street(s) where project is [Street Name(s)]: proposed] ------ (2) Depict the proposed location on attached map. Map attached with park location depicted ------ Check -Yes No (3) Park Project [New] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Park [New] Budget $ $ $ (4) Provide a description of the proposed project. Provide a Project Description: [Provide a more detailed explanation on d more detailed explanation in Attachment 1. Attachment 1.]

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(5) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (6A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and maintain the viability of neighborhoods where low and moderate-income families ------ reside; and, (3) revitalize older areas of the County. Short Term: Check One or More, As Applicable

O. Parks Projects [New] – Public Facility – Page 2 (8) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (9) Total Persons To Be Served by Proposed Project Total Number: [ ] (10) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (11) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 10 by the number entered for Item 9]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (12) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC FACILITIES ACTIVITIES P. Park Projects [Reconstruction]– Public Facility (1) Name of Street(s) where project is proposed ------ [Street Name(s)]:

(2) Depict the park location on attached map. Map attached with park location depicted ------ Check -Yes No (3) Park Project [Reconstruction] Budget CDBG Funds Applicant Funds Total Design Services [Engineer] $ $ $ Construction Supervision [Engineer] $ $ $ Construction Costs $ $ $ Total Park [Reconstruction] Budget $ $ $ Note: Include Accessibility Improvements in this budget if other renovation is proposed. If only accessibility improvements are proposed, skip this item, and complete Item 4. (4) Park Accessibility Improvements Budget CDBG Funds Applicant Funds Total Design Services [Architect/Engineer] $ $ $ Construction Supervision [Architect/Engineer] $ $ $ Renovation Costs $ $ $ Total Renovation Accessibility Budget $ $ $ OR Note: If only accessibility improvements are proposed, complete this item. If the overall park Budget is for Accessibility Improvements as a part of overall renovation includes Accessibility Improvements renovation Check and complete the Item 3 budget section. skip this item and complete item 3 of this form. (5) Provide a description of the proposed project. Project Description: [Provide a more detailed explanation on Attachment 1.] ------ (6) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (7A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. Long Term: CDPFLT PUBLIC FACILITIES: To provide for the acquisition, [See Page 16 of this Manual] construction, reconstruction, rehabilitation, or installation of public facilities and improvements to: (1) meet health and safety regulations, and (2) upgrade and maintain the viability of neighborhoods where low and moderate-income families ------ reside; and, (3) revitalize older areas of the County. Short Term: Check One or More, As Applicable

P. Park Projects [Reconstruction]– Public Facility – Page 2 (7B) HUD Performance Measures Select One Objective: Select One Outcome

(8) Applicant Project Priorities – CDBG This Project is Priority # [ ] of [ ] CDBG Projects (9) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition (10) Total Persons To Be Served by Proposed Project Total Number: [ ] (11) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (12) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 11 by the number entered for Item 10]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] (13) Other Items Attached A. Real Property Appraisals Check -Yes No B. Site Photos Check -Yes No C. Aerial Photos Check -Yes No D. Site Plans Check -Yes No E. Site Surveys Check -Yes No F. Construction Drawings/Plans Check -Yes No

4. Types of CDBG Projects PUBLIC SERVICES ACTIVITIES MUST BE A NEW SERVICE OR A QUANTIFIABLE INCREASE IN SERVICES TO BE ELIGIBLE [ONLY EQUIPMENT PURCHASES ] Q. Transportation Equipment Purchase [Public Services Capital Equipment] (1) Specify Type of Transportation Equipment Quantity Large Passenger [Transit-Type] Bus: [ ] ------ Mini-Bus: [ ] Large Van: [ ] Mini-Van: [ ] Totals [ ] (2) Transportation Equipment Purchase Budget CDBG Funds Applicant Funds Total Large Passenger [Transit-Type] Bus $ $ $ Mini-Bus ------ $ $ $ Large Van $ $ $ Mini-Van $ $ $

------ Other Vehicle -Describe: $ $ $ Totals $ $ $ (3) Provide a description of the proposed project. Provide a more Project Description: [Provide a more detailed explanation on complete description in Attachment 1. Attachment 1.]

------ (4) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (5A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. [See Page 16 of this Manual] Long Term CDPSLT PUBLIC SERVICES: To provide the resources necessary to improve the community's public services, including, but not limited to, employment, crime prevention, child care, physical and mental health, drug abuse, education, energy conservation, transportation, care for the elderly, welfare and recreational ------ needs.

CDST4 To provide funding, support or technical assistance to assist in the implementation of programs for special population groups such as the elderly, persons with disabilities, homeless persons, and persons suffering from various types of abuse.

CDST5 To provide funding, support, or technical assistance to private non-profit and public agencies meeting the public service needs of the County's low and moderate income population.

(6) Applicant Project Priorities – CDBG This Project is Priority # [ ] of [ ]CDBG Projects

Q. Transportation Equipment Purchase [Public Services Capital Equipment] - Page 2 (7) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition. If PSA is Countywide, please note . (8) Total Persons To Be Served by Proposed Project Total Number: [ ] (9) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (10) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 10 by the number entered for Item 9]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] If Proposed Project is a Presumed Benefit Project Complete Items 11 - 18, as Appropriate (11) Number of Elderly Persons [Age 62 and older] to be [ ] Served by Proposed Project, or (12) Number of Adults with Severe Disabilities to be [ ] Served [As defined by U.S. Census - See Page 9 ], or (13) Number of Battered Spouses to be Served, or [ ]

(14) Number of Abused Children to be Served, or [ ] (15) Number of Persons Living with AIDS to be Served, or [ ] (16) Number of Homeless Persons to be Served, or [ ] (17) Number of Illiterate Persons to be Served, or [ ] (18) Number of Migrant Farm Workers to be Served [ ] (19) Number of Female-Headed Households to be Served [ ] (20) Other Items Attached A. Equipment Brochures Check -Yes No B. Equipment Cost Estimates from Vendors Check -Yes No C. State Contract Information [If Applicable] Check -Yes No

4. Types of CDBG Projects PUBLIC SERVICES ACTIVITIES MUST BE A NEW SERVICE OR A QUANTIFIABLE INCREASE IN SERVICES TO BE ELIGIBLE [ONLY EQUIPMENT PURCHASES ] R. Health Services Equipment Purchase [Public Services Capital Equipment] (1) Specify Type of Equipment Describe Equipment:

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(2) Health Services Equipment Purchase Budget CDBG Funds Applicant Funds Total $ $ $ ------

(3) Provide a description of the proposed project. Project Description: [Provide a more detailed explanation on Attachment 1.]

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(4) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (5A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. [See Page 16 of this Manual] Long Term CDPSLT PUBLIC SERVICES: To provide the resources necessary to improve the community's public services, including, but not limited to, employment, crime prevention, child care, physical and mental health, drug abuse, education, energy conservation, transportation, care for the elderly, welfare and recreational ------ needs.

(5B) HUD Performance Measures S Select One Objective: Select One Outcome

R. Health Services Equipment Purchase [Public Services Capital Equipment] - Page 2 (7) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition. If PSA is Countywide, please note . (8) Total Persons To Be Served by Proposed Project Total Number: [ ] (9) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (10) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 9 by the number entered for Item 8]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] If Proposed Project is a Presumed Benefit Project Complete Items 11 - 18, as Appropriate (11) Number of Elderly Persons [Age 62 and older] to be [ ] Served by Proposed Project, or (12) Number of Adults with Severe Disabilities to be [ ] Served [As defined by U.S. Census - See Page 9 ], or (13) Number of Battered Spouses to be Served, or [ ] (14) Number of Abused Children to be Served, or [ ] (15) Number of Persons Living with AIDS to be Served, or [ ] (16) Number of Homeless Persons to be Served, or [ ] (17) Number of Illiterate Persons to be Served, or [ ] (18) Number of Migrant Farm Workers to be Served [ ] (19) Number of Female-Headed Households to be Served [ ] (20) Other Items Attached A. Equipment Brochures Check -Yes No B. Equipment Cost Estimates from Vendors Check -Yes No C. State Contract Information [If Applicable] Check -Yes No

4. Types of CDBG Projects PUBLIC SERVICES ACTIVITIES MUST BE A NEW SERVICE OR A QUANTIFIABLE INCREASE IN SERVICES TO BE ELIGIBLE [ONLY EQUIPMENT PURCHASES ] S. Recreation Equipment Purchase [Public Services Capital Equipment] (1) Specify Type of Equipment Describe Equipment:

------

(2) Recreation Equipment Purchase Budget CDBG Funds Applicant Funds Total ------ $ $ $

------

(4) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased through public services activities, and providing overall program administration and ------ management.

(5A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. [See Page 16 of this Manual] Long Term CDPSLT PUBLIC SERVICES: To provide the resources necessary to improve the community's public services, including, but not limited to, employment, crime prevention, child care, physical and mental health, drug abuse, education, energy conservation, transportation, care for the elderly, welfare and recreational needs.

------ Short Term: Check One or More, As Applicable

S. Recreation Equipment Purchase [Public Services Capital Equipment] - Page 2 (7) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition. If PSA is Countywide, please note. (8) Total Persons To Be Served by Proposed Project Total Number: [ ] (9) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (10) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 9 by the number entered for Item 8]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] If Proposed Project is a Presumed Benefit Project Complete Items 11 - 18, as Appropriate (11) Number of Elderly Persons [Age 62 and older] to be [ ] Served by Proposed Project, or (12) Number of Adults with Severe Disabilities to be [ ] Served [As defined by U.S. Census - See Page 9 ], or (13) Number of Battered Spouses to be Served, or [ ] (14) Number of Abused Children to be Served, or [ ] (15) Number of Persons Living with AIDS to be Served, or [ ] (16) Number of Homeless Persons to be Served, or [ ] (17) Number of Illiterate Persons to be Served, or [ ] (18) Number of Migrant Farm Worker to be Served [ ] (19) Number of Female-Headed Households to be Served [ ] (20) Other Items Attached A. Equipment Brochures Check -Yes No B. Equipment Cost Estimates from Vendors Check -Yes No C. State Contract Information [If Applicable] Check -Yes No

4. Types of CDBG Projects PUBLIC SERVICES ACTIVITIES MUST BE A NEW SERVICE OR A QUANTIFIABLE INCREASE IN SERVICES TO BE ELIGIBLE [ONLY EQUIPMENT PURCHASES ] T. Computer Equipment Purchase [Public Services Capital Equipment] (1) Specify Type of Equipment Describe Equipment:

------

(2) Computer Equipment Purchase Budget CDBG Funds Applicant Funds Total ------ $ $ $

------

(4) Gwinnett County Consolidated Plan Goal(s) Addressed by Goal(s) the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased through public services activities, and providing overall program administration and ------ management. (5A) Gwinnett County Consolidated Plan Priority Objective(s) Long and Short Term Priority Objective(s) Addressed by the Proposed Project. [See Page 16 of this Manual] Long Term CDPSLT PUBLIC SERVICES: To provide the resources necessary to improve the community's public services, including, but not limited to, employment, crime prevention, child care, physical and mental health, drug abuse, education, energy conservation, transportation, care for the elderly, welfare and recreational needs.

------ Short Term: Check One or More, As Applicable

T. Computer Equipment Purchase [Public Services Capital Equipment] - Page 2 (7) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition. If PSA is Countywide, please note . (8) Total Persons To Be Served by Proposed Project Total Number: [ ] (9) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (10) Percentage of Low and Moderate Income Persons To Be Percentage Low/Moderate Income: [ ]% Served by Proposed Project [Divide the number entered for Item 9 by the number entered for Item 8]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] If Proposed Project is a Presumed Benefit Project Complete Items 11 - 18, as Appropriate (11) Number of Elderly Persons [Age 62 and older] to be [ ] Served by Proposed Project, or (12) Number of Adults with Severe Disabilities to be Served [ ] [As defined by U.S. Census - See Page 9 ], or (13) Number of Battered Spouses to be Served, or [ ] (14) Number of Abused Children to be Served, or [ ] (15) Number of Persons Living with AIDS to be Served, or [ ] (16) Number of Homeless Persons to be Served, or [ ] (17) Number of Illiterate Persons to be Served, or [ ] (18) Number of Migrant Farm Workers to be Served [ ] (19) Number of Female-Headed Households to be Served [ ] (20) Other Items Attached A. Equipment Brochures Check -Yes No B. Equipment Cost Estimates from Vendors Check -Yes No C. State Contract Information [If Applicable] Check -Yes No

4. Types of CDBG Projects PUBLIC SERVICES ACTIVITIES MUST BE A NEW SERVICE OR A QUANTIFIABLE INCREASE IN SERVICES TO BE ELIGIBLE [ONLY EQUIPMENT PURCHASES ] U. Audio-Visual Equipment Purchase [Public Services Capital Equipment] (1) Specify Type of Equipment Describe Equipment:

------

(2) Equipment Purchase Budget CDBG Funds Applicant Funds Total ------ $ $ $

------

(4) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased through public services activities, and providing overall program administration and ------ management. (5A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. [See Page 16 of this Manual] Long Term CDPSLT PUBLIC SERVICES: To provide the resources necessary to improve the community's public services, including, but not limited to, employment, crime prevention, child care, physical and mental health, drug abuse, education, energy conservation, transportation, care for the elderly, welfare and recreational ------ needs.

U. Audio-Visual Equipment Purchase [Public Services Capital Equipment] - Page 2 (7) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition. If PSA is Countywide, please note . (8) Total Persons To Be Served by Proposed Project Total Number: [ ] (9) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (10) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 9 by the number entered for Item 8]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] If Proposed Project is a Presumed Benefit Project Complete Items 11 - 18, as Appropriate (11) Number of Elderly Persons [Age 62 and older] to be [ ] Served by Proposed Project, or (12) Number of Adults with Severe Disabilities to be [ ] Served [As defined by U.S. Census - See Page 9 ], or (13) Number of Battered Spouses to be Served, or [ ] (14) Number of Abused Children to be Served, or [ ] (15) Number of Persons Living with AIDS to be Served, or [ ] (16) Number of Homeless Persons to be Served, or [ ] (17) Number of Illiterate Persons to be Served, or [ ] (18) Number of Migrant Farm Workers to be Served [ ] (19) Number of Female-Headed Households to be Served [ ] (20) Other Items Attached A. Equipment Brochures Check -Yes No B. Equipment Cost Estimates from Vendors Check -Yes No C. State Contract Information [If Applicable] Check -Yes No

4. Types of CDBG Projects PUBLIC SERVICES ACTIVITIES MUST BE A NEW SERVICE OR A QUANTIFIABLE INCREASE IN SERVICES TO BE ELIGIBLE [ONLY EQUIPMENT PURCHASES ] V. Other Equipment Purchase [Public Services Capital Equipment] (1) Specify Type of Equipment Describe Equipment:

------

(2) Equipment Purchase Budget CDBG Funds Applicant Funds Total ------ $ $ $

------

(4) Gwinnett County Consolidated Plan Goal(s) Addressed Goal(s) by the Proposed Project. CD Increase the capacity of public facilities and public services to improve the social, economic, and physical environment for low- and moderate-income [See Page 16 of this Manual] individuals and families by acquiring, constructing, or rehabilitating public facilities, revitalizing older areas of the County, providing equipment purchased ------ through public services activities, and providing overall program administration and management. (5A) Gwinnett County Consolidated Plan Priority Long and Short Term Priority Objective(s) Objective(s) Addressed by the Proposed Project. [See Page 16 of this Manual] Long Term CDPSLT PUBLIC SERVICES: To provide the resources necessary to improve the community's public services, including, but not limited to, employment, crime prevention, child care, physical and mental health, drug abuse, education, energy conservation, transportation, care for the elderly, welfare and recreational needs. ------ Short Term: Check One or More, As Applicable

V. Other Equipment Purchase [Public Services Capital Equipment] - Page 2 (7) Project Location A. Street Address ------ B. City ------ C. State ------ D. Zip Code ------ E. Other location, if no street address, or if Countywide------ F. Map Attached -Map should identify the proposed Check Here If Map Attached: project and a Project Service Area (PSA), if a PSA is applicable to the proposed project. Failure to Submit Map Will Make Project Ineligible for Competition. If PSA is Countywide, please note . (8) Total Persons To Be Served by Proposed Project Total Number: [ ] (9) Number of Low and Moderate Income Persons To Be Number Low/Moderate Income: [ ] Served by Proposed Project (10) Percentage of Low and Moderate Income Persons To Percentage Low/Moderate Income: [ ]% Be Served by Proposed Project [Divide the number entered for Item 9 by the number entered for Item 8]. At least 51% of the total number of persons served by each non-housing project must be Low & Moderate Income for the project to be eligible for Gwinnett County CDBG funds. [See Income Table in Attachment 3 for Definitions and Income Limits.] If Proposed Project is a Presumed Benefit Project Complete Items 11 - 18, as Appropriate (11) Number of Elderly Persons [Age 62 and older] to be [ ] Served by Proposed Project, or (12) Number of Adults with Severe Disabilities to be [ ] Served [As defined by U.S. Census - See Page 9 ], or (13) Number of Battered Spouses to be Served, or [ ] (14) Number of Abused Children to be Served, or [ ] (15) Number of Persons Living with AIDS to be Served, or [ ] (16) Number of Homeless Persons to be Served, or [ ] (17) Number of Illiterate Persons to be Served, or [ ] (18) Number of Migrant Farm Workers to be Served [ ] (19) Number of Female-Headed Households to be Served [ ] (20) Other Items Attached A. Equipment Brochures Check -Yes No B. Equipment Cost Estimates from Vendors Check -Yes No C. State Contract Information [If Applicable] Check -Yes No

ATTACHMENTS FFY 2009

ATTACHMENT 1 PROJECT DESCRIPTION NARRATIVE - FFY 2009 USE FOR ALL APPLICATIONS FOR THE CDBG, HOME/ADDI, AND ESG PROGRAMS

USE AS MANY COPIES OF THIS PAGE AS YOU NEED TO DESCRIBE YOUR PROPOSED PROJECTS

Page [ ] of [ ] Attachment 1 Pages Submitted

ATTACHMENT 2 - FFY 2009 REQUIRED HOME PROGRAM ATTACHMENTS NOT APPLICABLE TO CDBG APPLICATIONS

ATTACHMENT 3 - FFY 2009 MAXIMUM INCOME LIMITS – CDBG PROGRAM - 2007

The U.S. Department of Housing and Urban Development releases maximum income limits for Public Housing and the Section 8 Rental Assistance Program each year. These are the income limits that also govern the Community Development Block Grant [CDBG] Program. The income limits are effective March 20, 2007 and remain in effect until HUD publishes new income limits.

The following table contains the new CDBG/Public Housing/Section 8 income limits, listed by household size and by percent of median household income. Please remember that total household income includes income from all members of the household.

Area: Atlanta Metropolitan Area [Includes Gwinnett County] Effective Date: March 20, 2007

CDBG Maximum Family/Household Income Limits – Gwinnett County, Georgia [Income is Counted From All Persons Living In the Household] - Per HUD @ www.huduser.org/datasets /il/il07 - Effective 3/20/07 Family/Household Size Extremely Low Income Very Low Income Low Income [Total Number of Persons [0-30% Median [31-50% Median [51-80% Median in Household] Family/Household Income] Family/Household Income] Family/Household Income] 1 $14,950 $24,900 $39,850 2 $17,100 $28,500 $45,550 3 $19,200 $32,050 $51,250 4 $21,350 $35,600 $56,950 5 $23,050 $38,450 $61,500 6 $24,800 $41,300 $66,050 7 $26,500 $44,150 $70,650 8 $28,200 $47,000 $75,200

The 80% of Median figures are used for most CDBG projects. The 30% and 50% figures are used only for housing programs.

ATTACHMENT 4 - FFY 2009 MAXIMUM INCOME LIMITS – HOME PROGRAM - 2007 NOT APPLICABLE TO CDBG APPLICATIONS

ATTACHMENT 5 GWINNETT COUNTY CDBG PROGRAM PROJECT BENEFICIARIES SURVEY FORM FFY 2009

PART A:

Project Name

Project Location

Jurisdiction Census Tract

Attach Project Service Area [PSA] Map

Brief Description of Project

PART B:

1. Street Address of Person(s) Interviewed

City _ State GA ZIP

2. How Long at Present Address Years Months

3. Do You Currently Own or Rent the Home Where You Live?

(A) Own (B) Rent (C) Other

4. Number of Persons in Your Household (Including Yourself)

5. Total Household (Family) Income (Estimate to the Best of Your Knowledge)

(A) $ Per Year (B) $ Per Month (C) $ Per Week

6. Source(s) of Income: (A) (B)

(C) (D)

7. Head of Household is Elderly (Age 62 or Older) Yes No

[CONTINUED ON PAGE 2]

Form Date: 01/08/2008

Gwinnett County CDBG Program Project Beneficiaries Survey Form - FFY 2009 Page 2

Household Address:

City: State: GA ZIP CODE:

8. Race/Ethnicity of Persons Interviewed Number of Number of Total [As Defined by Census 2000 and HUD] Non-Latino Latino or Number of Enter Number of Persons in the Household from Each Racial/Ethnic or Non- Hispanic Persons Classification Hispanic

Column 1 Column 2 Column 3 A. Single Race, By Ethnicity of Household (1) White (2) Black/African-American (3) Asian (4) American Indian/Alaskan Native (5) Native Hawiian/Other Pacific Islander B. Multi-Race, By Ethnicity of Household (1) American Indian/Alaskan Native & White (2) Asian & White (3) Black/African-American & White (4) American Indian/Alaskan Native & Black/African-American (5) Balance/Other C. Total Persons In Household [Total 8.A.(1)-A.(5) + 8.B.(1)-B.(5)] [Column 3 Total Should be Same as #4 on Page 1 of this Survey]

Note: Gwinnett County is required to report racial/ethnic data, annually, to HUD for all HUD Entitlement Grant programs [CDBG, HOME/ADDI, and ESG]. Beginning in 2003, HUD Entitlement Grantees and their Subrecipients/CHDO's are required to report services by the racial/ethnicity categories listed in this document.

PART C:

Name of Interviewer

Signature of Interviewer

Date of Interview

Thank you for your time and cooperation in completing this survey. If you have any comments or remarks, please write them or have the interviewer write them on the back of this form. If you have any questions, please contact Mr. Tony Lowe, Gwinnett County Community Development Program, 575 Old Norcross Road, Suite A, Lawrenceville, Georgia 30045-4367. (770) 822-5190 - TDD (770) 822-5195; email: [email protected].

Form Date: 01/08/2008

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